在COVID-19患者心脏骤停后目标温度管理
Dhanesh D Binda1, Connor M Logan1, Victoria Rosales1
1Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
Therapeutic hypothermia and temperature management
|August 15, 2023
概括
有针对性的温度管理 (TTM) 在非COVID-19心脏骤停中具有有限的效用. 然而,维持正常热量可能会优化COVID-19心脏骤停幸存者的结果,因为发烧或低温会增加死亡风险.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
背景情况:
- 针对COVID-19心脏骤停患者的有针对性的温度管理 (TTM) 有有限的证据.
- 发烧和低温与COVID-19患者的死亡率增加有关.
- 在非COVID-19心脏骤停中,ROSC后的活性冷却对死亡率或神经结果没有显著影响.
研究的目的:
- 系统地审查和元分析有关温度在COVID-19结果中的预测值的现有数据.
- 评估活跃冷却与非COVID-19心脏骤停患者的结果之间的关联.
- 为在COVID-19心脏骤停的幸存者中提供TTM实用性的建议.
主要方法:
- 来自PubMed,Embase和Web of Science数据库的研究的系统审查和元分析 (2022年8月).
- 两个搜索策略: (1) 温度作为COVID-19中的预测因素, (2) 在非COVID-19心脏骤停中ROSC后的活性冷却.
- 森林地块被用来总结包含的研究结果.
主要成果:
- 没有研究直接评估了COVID-19心脏骤停患者的TTM.
- 过热 (RR=1.87) 和低温 (RR=1.77) 与COVID-19患者的死亡率较高有关.
- 在非COVID-19心脏骤停患者中,主动冷却并没有显著改变死亡率 (RR=0.94) 或有利的神经结果 (RR=1.05).
结论:
- 需要进一步的研究来评估TTM,特别是在COVID-19心脏骤停的幸存者中.
- 鉴于异常温度与COVID-19死亡率的关联以及在其他心脏骤停病例中活性冷却的有限益处,建议TTM与正常热量相比.
- 保持核心体温在37°C左右,被假设为COVID-19心脏骤停幸存者的最佳选择.
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